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(a) Radiographic image of an atypical fracture pattern of the left femoral shaft (lateral cortical thickening, transverse fracture line and medial cortical spike) in an 86-year-old female with a 10-year history of alendronate therapy; (b) An intraoperative image of thickened lateral cortex and narrowed femoral medulla (arrow); (c) Radiographic image of the fracture treated with intra-medullary nailing at 2 years.
